Money remains at the root of healthcare disparities

The Affordable Care Act (ACA) helped narrow the gap in one of three areas of health disparities--health insurance--but has had only limited success in ensuring access to good medical care and in improving the health of diverse groups, according to an article in the Harvard Gazette.

Money, or rather the lack of it, is still the biggest factor in health disparities, according to the article, which noted that life expectancy across the country varies by up to 30 years between the richest and poorest counties. That gap has more than doubled in recent years, and for the poor persists across races and ethnicities.

The ACA requirement that insurance companies cover people regardless of pre-existing conditions has reduced disparities in medical care and health status between people of different income levels, according to the article. Studies indicate having health insurance can make it easier for people to treat chronic conditions including diabetes and high blood pressure, noted the article, which quoted several Harvard analysts.

But the ACA could work against efforts to reduce health disparities by unfairly penalizing urban safety-net hospitals, which serve large populations of poor people with chronic conditions, for poor outcomes, according to the article.

Researchers have found that limited access to high-quality hospitals is largely to blame for racially based health disparities, FierceHealthcare previously reported. Minorities represent a disproportionate share of America's poor, as the Harvard article noted.

Patient stereotyping also has a role in health disparities, according to previous research. Patients who feel judged for their socioeconomic status, race, gender and weight, among other factors, are less likely to follow doctors' instructions and are more likely to mistrust providers.